Non-timber Forest Products (NTFPs), an important provisioning ecosystem services, are recognized for their contribution in rural livelihoods and forest conservation. Effective management through sustainable harvesting and market driven commercialization are two contrasting aspects that are bringing challenges in development of NTFPs sector. Identifying potential species having market value, conducting value chain analyses, and sustainable management of NTFPs need analysis of their use patterns by communities and trends at a regional scale. We analyzed use patterns, trends, and challenges in traditional use and management of NTFPs in the southern slope of Kangchenjunga Landscape, Eastern Himalaya and discussed potential implications for conservation and livelihoods. A total of 739 species of NTFPs used by the local people of Kangchenjunga Landscape were reported in the reviewed literature. Of these, the highest number of NTFPs was documented from India (377 species), followed by Nepal (363) and Bhutan (245). Though the reported species were used for 24 different purposes, medicinal and edible plants were the most frequently used NTFP categories in the landscape. Medicinal plants were used in 27 major ailment categories, with the highest number of species being used for gastro-intestinal disorders. Though the Kangchenjunga Landscape harbors many potential NTFPs, trade of NTFPs was found to be nominal indicating lack of commercialization due to limited market information. We found that the unsustainable harvesting and lack of marketing were the major constraints for sustainable management of NTFPs sector in the landscape despite of promising policy provisions. We suggest sustainable harvesting practices, value addition at local level, and marketing for promotion of NTFPs in the Kangchenjunga Landscape for income generation and livelihood improvement that subsequently contributes to conservation.

Non-timber forest products (NTFPs) are the most important provisioning services people obtain from forest ecosystems [1]. The importance of NTFPs in rural livelihoods and forest conservation has been well recognized as they provide income generation opportunities to millions of people around the world [2–5], and they are also a major source of supplementary food, medicines, fibre, and construction materials [6, 7]. In developing countries, biological resources obtained from forests, mostly NTFPs, may contribute as much as 20–25 % of income to rural people [7]. However, the economic potential of NTFPs is highly contextual and depends on a combined set of socio-cultural, ecological, geo-political, and economic conditions. Nevertheless, access to market/commercialization of NTFPs and sustainable harvesting are two important aspects that need attention for sustainable development of the NTFP sector (also see [8]).

The ecological diversity of the Himalaya makes the area a habitat of a vast range of NTFPs. In the Himalayan region, harvesting NTFPs is a tradition that also contributes significantly to the local economy. Some NTFPs play an important role in traditional health care systems, while others have important cultural values and are sources of food and housing material [9–11]. Among all categories of NTFPs, medicinal plants have received much focus while the contribution of other categories of NTFPs has been overlooked. For example, the contribution of wild edible plants towards food security and income generation has been undervalued in Nepal [12].

Common threats to NTFPs in the Himalayan region include unsustainable harvesting and habitat loss due to land use change, deforestation and over-grazing [13, 14]. Several other challenges have also been identified for sustainable management of NTFPs, such as policies that are ambiguous or poorly implemented due to the lack of resources, lack of comprehensive information on the ecology of the species and its socio-ecological impacts, and poor infrastructure for bioprospecting [15–17]. However, unsustainable harvesting is one of the major issues that affects ecological processes at many levels, from individual and population to community and ecosystem [2, 18]. Commercialization of NTFPs is another important aspect involving different processes such as production, collection, processing, storage, transport, marketing, and sale. Marshall et al. [19] found that product marketing and sale were the most important of all factors that constrained overall success of NTFPs commercialization. However, Ghate et al. [20] found a clear relationship between the degree of proximity to the market and NTFP dependence; remote places with low market access had high NTFPs dependency.

The demand for NTFPs is increasing not only in local markets, but also in international markets. Therefore, some important steps to facilitate integration of NTFPs into the development agenda that benefits local communities include identifying potential species having trade value and conducting research on their ecology and sustainable harvest levels; conducting analyses on value chain and use patterns; and analyzing trends and challenges in marketing and management [21]. Here we focus on these aspects of NTFPs in the Kangchenjunga Landscape within the Eastern Himalaya [22] and explore the implications for conservation and livelihoods.

Study area

The Kangchenjunga Landscape is a transboundary landscape shared by Bhutan, India, and Nepal. It is one of the richest landscapes in the Hindu Kush Himalaya (HKH) in terms of cultural and biological diversity and forms part of the Himalaya Biodiversity Hotspot, one of 34 global Biodiversity Hotspots [23]. It extends over 25,000 sq. km within 260 21′40.49″ to 2807′ 51.25″ North latitudes and 87030′30.67″ to 900 24′31.18″ East longitudes (Fig. 1). The altitude in the landscape ranges from 50 masl in the south to 8,586 masl, the height of Mount Kangchenjunga–the world’s third highest peak. Vegetation zones in the landscape is comprised of tropical, subtropical, temperate, subalpine, alpine, and nival.

Fig. 1

The Kangchenjunga Landscape in the Eastern Himalaya

The Kangchenjunga Landscape provides a range of ecosystem services that supports millions of people [24]. However, like many other landscapes worldwide, biodiversity and ecosystems within the landscape face threats mainly from anthropogenic pressures [25] and global climate change [26]. As a result, the people living in the landscape are economically, physically, and socially vulnerable [25, 27].

Recognizing the global and regional significances and challenges that lie within this landscape, the Kangchenjunga Landscape Conservation and Development Initiative (KLCDI) has been initiated by the governments of Bhutan, India and Nepal to achieve biodiversity conservation and sustainable development by applying ecosystem approaches to transboundary landscape management [22]. One of these priority areas is sustainable utilization of NTFPs in the Kangchenjunga Landscape. Several species of high value NTFPs that are also threatened are found in the landscape such as Chiraito (Swertia chirayita), Panch aunle (Dactylorhiza hatagirea), Kutki (Neopicrorhiza scrophulariiflora), Laghupatra (Podophyllum hexandrum) and Lauth salla (Taxus wallichiana).

Data collection and analysis

We reviewed scientific studies published in journals and books on traditional uses of NTFPs in the Kangchenjunga Landscape. Various online databases were used (ISI Web of Science, Scopus, and Google Scholar) using specific search terms such as ‘non-timber forest products’, ‘medicinal plants’, ‘wild edible plants’, and ‘Kangchenjunga Landscape’, ‘Nepal’, ‘India’, ‘Sikkim’, ‘Darjeeling’, and ‘Bhutan’. We also explored hard copies of relevant publications. We reviewed a total of 47 publications and one database to enumerate the NTFPs in the Kangchenjunga Landscape. The precision of species identification in this review was dependent on the original source. However, we verified currently accepted name(s) in online nomenclature sources (http://www.theplantlist.org and http://www.tropicos.org). Vernacular names when available have also been provided. A master list was produced providing Linnaean taxonomy, vernacular name(s), mode(s) of use, and reference(s) for each species (Table 1). We also collected trade data and reviewed policy documents on NTFPs of Bhutan, India and Nepal.

Table 1

NTFPs used by the local people of the Kangchenjunga Landscape, Eastern Himalaya

Fruits: Edible and also used in the treatment of diarrhea, dysentery (Taplejung: [88]; Panchthar: [67]; Ilam: [73]) and stomach problems (Taplejung: [88]; Ilam: [73]). Dried and extract used in diarrhea, swellings and wounds (Sikkim: Database). Juice used as food preservative; juice boiled with water and mixed with raw egg and the mixture given to treat diarrhea (Sikkim: [11]) and dysentery (Darjeeling: [80]; Sikkim: [11]). Juice administered orally during blood dysentery (Sikkim: [79]). Boiled and isolated vinegar used to make pickles (Ilam: [94]).

Plant: Used as good winter fodder (Taplejung: [81, 87]). Roots: Given to cattle as tonic; juice and roasted seeds taken in cough and diarrhoea (Panchthar: [67]; Ilam: [73, 77]). Flowers and fruit: Suggested to cure influenza and body ache (Sikkim: [75]). Fruit: Used as pickle and also in typhoid, nausea, and vomiting (Darjeeling: [78]). Seeds: Used in case of bodyache, headache, and faint (Panchthar: [67]; Ilam: [73]).

33

Heracleum wallichii DC.

Herb

Apiaceae

Chimphing (Np)

3600-4100

Roots: Used as medicine (KL Bhutan: [71]).Used as tonic and aphrodisiac (Darjeeling: [78]). Juice taken to cure diarrhea (Sikkim: [11]). Seeds: Taken in diarrhea and gastric disorders (Sikkim: [75]), used as chatni (Sikkim: [11]). Decoction of dried seeds taken in influenza (Darjeeling: [78]; Sikkim: [11]).

Roots and fruits: Used for cuts, wounds, colic, gastritis, and intestinal pain (KL Nepal: [83]). Roots: Smoke inhaled in case of faint, fever, and headche. Also used as fodder (Taplejung: [81]). Decoction taken to get relief from pain and fever (Ilam: [76]). Flowers and leaves: Smooked to treat headache (KL Nepal: [53]). Leaves: Leaves, aromatic, carminative. Fruits: Used in skin diseases and scabies (Sikkim: Database).

40

Alstonia scholaris (L.) R. Br.

Tree

Apocynaceae

Chhatiwan (Np); Chhatni (S)

100-1400

Bark: Used in malarian fever and also given to lactating mothers for increasing milk (Jhapa: [66]). Extract used to treat piles (KL Nepal: [53]). Filtered bark juice used to cure leanness in man (Jhapa: [68]). Powder mixed with common salt and given to cattle to cure fever (Sikkim: [97]). Bark, latex and flowers: Used as tonic and in fever and leucoderma (Sikkim: [97]).

Shoots: Edible (KL Bhutan: [70]). Edible and also used as a substitute for rope, as cable for suspension bridges, for wickerwork, baskets, and containers. Thicker cane used for makingfurniture frames, walking sticks and umbrella handles (KL Bhutan: [100]).

Roots: Stocks given orally in case of food poisoning (Darjeeling: [52]). Inflorescence: Powdered and taken with water to relieve body pain (Sikkim: [11]). Given in food poisoning (Darjeeling: [74]). Flowers: Used as appetizer and taken in diabetes (Sikkim: [69, 79], Database). Taken as curry (Sikkim: [89]).

Roots: Paste sticked on and around swelling region to prevent cutaneous infection (Jhapa: [68]). Decoction given in urinary infections, and also with decoction of Plumeria acuta given in gonorrhoea and spermatorrhoea (Jhapa: [66]).

107

Calendula officinalis L.

Herb

Asteraceae

2600-4400

Leaves and flowers: Used as antiseptic, antifungal, diaphoretic, stimulant, antispasmodic and in small pox; also used in healing wounds, ulcers, and burns (Sikkim: Database).

Roots: Used in treatment of snake and scorpion bite (Jhapa: [66]). Leaves and tender shoots: Used to treat cut and wounds and jaundice (Panchthar: [67]). Leaves: Infusion used in catarrhal (Jhapa: [66]).

Stem and Leaves: Extract used on cut and bruises to stop bleeding and infection (Darjeeling: [80]; Sikkim: [11], Database).

116

Eupatorium odoratum L.

Herb

Asteraceae

Aule banmara (Np); Daubanthu (Me)

400-1500

Leaves: Juice applied on cut and injury as haemostatic and to check nasal bleeding, extract dropped in nose to cure severe headache (Jhapa: [68]). Extract also used in cuts and wounds (Sikkim: Database).

Plant: Juice taken in headache and conjunctivitis (Ilam: [73, 76]). Stalks: Extracts from stalks used for venereal disease (Sikkim: Database). Fruit: Juice applied as an anti-leech agent (Taplejung: [88]). Shoots and leaves: Used to make pickle and jam (Ilam: [94]).

Roots and bark: Used as emetic (Panchthar: [67]) and also used to treat diarrhea and dysentery (Darjeeling: [86]; Panchthar: [67]; Sikkim: Database). Roots: Decoction given in urinary infection, also with decoction of Plumaria acuta given in gonorrhoea and spermatorrhoea (Jhapa: [66]). Flowers: Used as medicine (KL Bhutan: [71]). Buds cooked as vegetable (Jhapa: [92]). Pickled and eaten twice daily to get relief from diarrhea and dysentery (Jhapa: [68]). Paste applied externally on small pox in children (Sikkim: [79]). Exude used as gum (KL Bhutan: [70]).

Tubers: Cooked as vegetable; juice taken as oral contraceptives and also used in lice problems (Ilam: [76]; Taplejung: [82]).

229

Dioscorea pentaphylla L.

Climber

Dioscoreaceae

Kusok (Lp); Aser, Bantarul, Bhyakur (Np)

600-1500

Tubers: Boiled and eaten after submerging them whole night in cold water (Jhapa: [92]). Boiled and taken orally as anthelmintic and wormifuge especially against tapeworm (Darjeeling: [52]).Tubers and shoots: Used as tonic and can also cure swelling (Sikkim: [75]).

Plant: Extraction given to lactating mother to increase the milk prodcution. Root: Given to stop vomitting (Jhapa: [66]). Young shoots: Used to treat excessive bleeding during menstruation and also in gonorrhea (Jhapa: [68]). Latex: Applied on pimples and old wounds (Jhapa: [68]) and also to treat warts and cuts (Darjeeling: [74]).

Roots: Used for skin diseases. Tied as an amulet on neck of children to stop vomiting (Jhapa: [66]). Leaves: Juice used to cure headache, boils, and dysentery; paste used to cure jaundice (Sikkim: Database). Warmed with mustard oil and massaged on the body of post delivery women to cure body pain (Jhapa: [66]). Seeds: Used as medicine (KL Bhutan: [71]). Endosperm applied as cream on dryness of skin to cure cracking heels (Jhapa: [68]).

Plant used against animal bite;useful as maturant for boils and ebcesses (Sikkim: Database). Roots: Used as carminative (Sikkim: Database, [79]). Paste applied on boils (Sikkim: [79]). Bark: Used to control diarrhea (Sikkim: Database). Flowers: Used as laxative (Sikkim: Database). Leaves: Used as fodder (Ilam: [73]). Shoots: Used as vegetable (Ilam: [94])

Bark: Useful in skin disease (Sikkim: Database) and diarrhea (Sikkim: Database, [74]). Leaves: Used as demulcent (Sikkim: Database). Paste applied in factured bone (Sikkim: [97]). Seeds: Used as tonic and aphrodisiac, and also given to treat snake bite (Panchthar: [67]; Sikkim: Database). Roasted and consumed (Ilam: [92]). Seeds and leaves: Given in dysentery and used as laxative (Sikkim: [75]).

Leaves: Used for treating skin diseases, extraction taken orally taken to purify blood, and also used as laxative (Jhapa: [66]). Fruits: Used as medicine (KL Bhutan: [71]). Used as diuretic, purgative, and laxative (Panchthar: [67]). Used for asthma, diabetes, and eczema (Sikkim: Database). Paste used to treat the whopping cough (Jhapa: [68]).

Leaves: Paste used in boils, blisters, and ulcers (Jhapa: [66]). Roots and seeds: Used as antipyretic and aphrodisiac (Panchthar: [67]). Roots: Used in delirium (Jhapa: [66]). Seeds: Used as medicine (KL Bhutan: [71]).

Fruit: Used to extract oil (KL Bhutan: [93]). Juice taken or eaten raw in fever (Darjeeling: [78]). Seeds: Seed oil applied on skin diseases and leprosy (Sikkim: [75]), also used for massage purpose for infants (Sikkim: [79]). Ripen seeds roasted and the oil extracted to use in various purposes (Ilam: [94]).

Bark: Paste used for poisoning fish. Fruit: Edible (KL Bhutan: [70]). Boiled in water to extract dye. Used to treat pneumonia and wounds (Panchthar: [67]). Seeds: Eaten as tonic or to treat throat pain; hard cover of the fruit applied on gout or to treat throat and chest pain (Taplejung: [87, 88]).

Leaves: Crushed with Euphorbia hirta and let to inhale for sinusites and nasal infection (Jhapa: [68]). Decoction massaged on forehead to relieve headache; drops poured in nostril to cure sinusitis and earache; juice taken in asthma, and also applied in geneital organs to cure venereal diseases (Jhapa: [66]).

Bark: Used as medicine (KL Bhutan: [71]). Given in gonorrhea (Sikkim: Database).Extract used in stomach disorders (Sikkim: [79]). Leaves: Used as stimulant in rheumatism, and also in colic and diarrhea (Sikkim: Database). Rubbed on the body to cure scabies (Sikkim: [11]), throat allergy and to increase appetite (Jhapa: [68]). Used as condiments (KL Bhutan: [70]). Ilam: [94]).

Bark and fruit: Used as aromatic and carminative (Sikkim: [85]). Fruit: Used in cough, cold, fever, and cholera; fried in butter and used during gastritis; also used in pickle (Taplejung: [87, 88]). Given to treat headache (Panchthar: [67]). Seeds: Powder taken to stop vomiting (Sikkim: [11]).

377

Litsea cubeba (Lour.) Pers.

Tree

Lauraceae

Siltimur (Np); Tanghaercherkerng (L)

Flowers: Used in stomach disorders (Sikkim: [11, 75], Database). Fruit: Taken orally as carminative (Sikkim: [85]). Used to make chutney (Darjeeling: [80]; Sikkim: [11]). Dried fruits used in nausea and giddiness (Darjeeling: [80]).

Roots: Decoction given in urinary complaints and diabetes. Leaves: Extract of young leaves or tender shoots applied on forehead and to treat pneumonia, fever and common cold (Darjeeling: [74]). Leaves and flowers: Paste used in foot sores of cattle (Darjeeling: [49]).

411

*Azadirachta indica A. Juss.

Tree

Meliaceae

Meemee (S); Neem (Np); Nimbilai (Me)

60-1200

Plant: Used as an antiseptic and febrifuge. Useful in treatment of small pox, and as tooth brush, prophylactic for mouth and teeth (Sikkim: Database). Leaves: Cooked with rice and eaten during the name giving ceremony of newly born child. Boiled in water and bath taken with warm water to cure scabies and eczema. Dried leaf power taken as blood purifier (Jhapa: [92]). Juice taken for blood purification and intestinal worms, also applied externally on wounds, sores, blisters, ans skin diseases (Jhapa: [66]). Fresh/dried leaves chewed to control diabetes (Sikkim: [79, 96]). Bark powder used as insecticide (Sikkim: [79]).

Roots: Used as astringent, and in biliousness, heart pain, vomiting, and leucoderma. Leaves: Juice taken orally as anthelmintic (Sikkim: [85]). Bark: Used as anthelmintic (Jhapa: [66]). Fruit: Used in leprosy (Jhapa: [66]).

414

Toona ciliata M. Roem.

Tree

Meliaceae

Tooni (Np); Toon (S)

200-1700

Bark: Pounded and given to cure toothache (Jhapa: [66]; Sikkim: [79]). Flowers and fruit: Use to extract dye (KL Bhutan: [70]). Fruit: Used for chestpain, fever and measles (Sikkim: [79]).

Root: Dipped in water and sprinkled in poultry farm to prevent from birld flu. Leaves: Paste applied on boils for opening (Sikkim: [11]).

420

*Tinospora sinensis (Lour.) Merr.

Climber

Menispermaceae

Garjo, Gurjo (Np); Sarasatilata (S)

Roots: Useful in diabetic. Extract used in menstruation disorders and piles (KL Nepal: [53]). Stem and roots: Infusion given in fever (Darjeeling: [69, 78]). Used to make broom (KL Bhutan: [100]). Leaves: Warmed and wrapped around the fractured and painful joints (Jhapa: [66]). Fruit: Boiled in milk and drunk to get rid from tuberculosis (Darjeeling: [74]). Used as medicine (KL Bhutan: [71]).

Bark: Macerated with flowers of Hibiscus rosa-sinensis and taken to purify the blood and also to arrest bleeding (Jhapa: [66]).

447

Embelia ribes Burm.f.

Shrub

Myrsinaceae

Buibidans (Np)

Seeds: Used as medicine (KL Bhutan: [71]). Powdered with milk and given to dog for anthelmintic efficacies (Sikkim: [84]). Fruit: Crushed and given to pigs to kill tapeworm; also used as appetizer for cattle (Sikkim: [84]).

448

Maesa chisia Buch.-Ham. ex D. Don

Shrub

Myrsinaceae

Bilaune (Np); Purmu Kung (L)

Roots and leaves: Used as insecticide and anthelmintic (Sikkim: [75]).

Bark: Paste used for dislocated bones. Leaves: Boiled and decanted water taken to control malaria fever. Flowers: Offered to god and goddesses (Sikkim: Database). Leaves and flowers: Pounded with warm water and given to woman to ease expulsion of placenta (Jhapa: [66]).

Roots: Used in antifertility (Jhapa: [66]). Used to make traditional yeast or starter called 'Marcha' to make local wine (Darjeeling and Sikkim: [108]). Roasted with potatoand taken orally in jaundice (Darjeeling: [105]).

500

Arundinaria intermedia Munro

Herb

Poaceae

Malingo (Np)

2000-3000

Plant: Used to make mats, baskets and to construct temporary huts (Sikkim: [89]). Leaves: Used as fodder (Ilam: [73]). Young shoots: Used as vegetables (Ilam: [73]).

Plant: Juice taken orally to cure scabies, cut, wound, epilepsy, piles (Ilam: [73, 76]), and juice along with garlic and warm mustard oil used to rub on body to relieve bodypain (Jhapa: [66]). Roots: Juice used in piles; paste used to heal cuts and wounds (Sikkim: [11]). Freshly prepared juice taken to cure liver cirrhosis (Darjeeling: [52]). Roots and leaves: Decoction used to cure diarrhea and dysentery (Sikkim: [11]).

509

Dendrocalamus hamiltonii var. hamiltonii Nees & Arn. ex Munro

Herb

Poaceae

Choya Bans, Tama (Np)

Young shoots: Chopped and fermented in tight bamboo or glass bottles to make sour pickle locally called 'Mesu' (Darjeeling: [101, 108]; Ilam: [94]). Used to make water pipes, water vessels, in house construction and also consumed as vegetable (Sikkim: [89]).

Roots: Extract used in boils and worms (Ilam: [73, 76, 77]; Sikkim: [79]). Paste applied on boils (Darjeeling: [52]). Decoction of young roots taken in case of bronchial problem (Darjeeling: [49]). Leaves: Used as abortifacient (Panchthar: [67]). Flowers: Poultic of young flowers used in rheumatic pain and skin swelling (Darjeeling: [49]). Inflorescence: Used to make broom (KL Bhutan: [100]).

Rhizomes: Used for cholera, rheumatism (KL Nepal: [83]), and also to treat rabies and stomachache (KL Nepal: [53]). Paste given in diarrhea (Ilam: [73]). Buti (Amulet) prepared with tuber and tied on the body of a baby to keep far from bad spirit (Taplejung: [81]).

Roots: Paste applied externally to control bleeding; chewed in cough and cold (Sikkim: [79]). Juice taken in cough and cold, toothache, and high altitude sickness (Darjeeling: [74]). Fruit: Ripen fruits cosumed (KL Bhutan: [70]; Ilam: [94]). Leaves and fruit: Pounded and administered with lukewarm water to cattle to treat diarrhea and dysentery, also used as diuretic for cattle (Sikkim: [84]).

Roots: Used for breast disease, stomach and lung disorders, and indigestion; also used as incense (KL Nepal: [83]). Stem: Used as brooms (Taplejung: [87]). Leaves and flowers: Used in making tea (Taplejung: [87]).

Roots: Powder taken to treat dysentery (Darjeeling: [80]; Sikkim: [85]). Bark: Decoction given in fever (Darjeeling: [78]). Fruit: Used as antipyretic and in treatment of typhoid; eaten as vegetable (Darjeeling: [80]; Sikkim: [89]). Seeds: Used to make chutney and taken with food to improve appetite (Darjeeling: [91]; Sikkim: [79]).

Fruit: Juice used to cure burnt part of the body; also used for epilepsy (Sikkim: Database). Extract applied on head to remove dandruff and lice (Darjeeling and Sikkim: [69]; Sikkim: [11]). Used to extract oil (Ilam: [94]). Fruit and root bark: Used as tonic, anthelmintic, purgative, in asthma and piles (Darjeeling and Sikkim: [69]).

Plant: Decoction used in eye troubles (Jhapa: [66]). Leaves: Extract drunk and also applied externally on the body as a remedy for the babies weeping all days (Jhapa: [68]). Young leaves taken in diabetes (Sikkim: [75]). Roots: Decoction taken orally in diarrhea and dysentery (Jhapa: [66]).

636

Smilax zeylanica L.

Climber

Smilacaceae

Kukur Dainey (Np)

150-1500

Plant: Used in Urinary complaints and dysentery. Roots: Taken as tonic (Sikkim: Database).

Seeds: Used as medicine (KL Bhutan: [71]).Used to treat scabies (Jhapa: [68]). Used as narcotic and also to treat dandruff and hairfall (Panchthar: [67]).Given orally against rabies, nervousness, nausea and hysteria (Darjeeling: [52]).

Whole plant: Used as medicine (KL Bhutan: [71]).Leaves and flowers: Used for incense (Taplejung: [87, 88]). Stem: Used to treat cough and cold (Taplejung: [87, 88]).

656

Schima wallichii (DC.) Korth.

Tree

Theaceae

Chilone (Np); Sakriphal (S)

900-2100

Bark: Crushed with common salt and used as vermicide in cattle (Sikkim: [97]). Rubbed on caterpillar infected portion to remove hair (Sikkim: [11]). Pounded and given to cure fever and stomach pain, and also applied in bone fracture and sprain (Jhapa: [66]). Bark paste with the bark of Bridelia retusa applied externally on deep cuts and wounds (Sikkim: [79]).

Roots: Used for intestinal troubles (Sikkim: Database). Decoction given in food poisoning (Sikkim: [79]; Darjeeling: [91]; KL Nepal: [83]). Used as a substitute of Aconitum sp. (Sikkim: [79]). Bark: Decoction given to treat fever (Sikkim: Database). Juice used to treat intestinal worms and used as anti-leech agent; powder cause nasal irritation (Taplejung: [87]). Used to make handmade paper (KL Nepal: [83]; Sikkim: [11]). Leaves: Given to baby goat during diarrhea and fever; stalks used to make locally used mats (Sikkim: [11]).

Plant: Juice used to treat fever, ulcer, asthma, and cough (Ilam: [73]). Leaves: Used to treat sinusitis and rheumatism (Panchthar: [67]); also used as repellent for insects and bedbugs (Jhapa: [66]). Stem: Juice bath taken to treat body swelling, common cold and influenza (Darjeeling: [74]).

Seeds: Used as medicine (KL Bhutan: [71]). Used in indigestion and vomiting (Ilam: [76]).Decoction used to gargle to treat teeth and gum infection (Sikkim: [79, 91]). Oil applied on eye-lids to allay inflammation of the eye in cattle; paste applied externally as antidote for scorpion-sting and insect bites (Sikkim: [84]).

Rhizomes: Used in cough and bronchitis (Taplejung: [82]). Also used as appetizer, tonic, carminative and applied to bruises and sprains; powder used as anthelmintic; oil useful in the treatment of early stage of cervix cancer (Sikkim: [69]).

Rhizomes: Used as medicine (KL Bhutan: [71]). Paste prepared from powder and applied on the fractured bones (Darjeeling: [52]).

695

Curcuma zeodaria Rosc.

Herb

Zingiberaceae

Kalo Hardi (Np); Zalmathangru- tsalu (Sh)

Rhizomes: Used as medicine (KL Bhutan: [71]).Eatern raw to cure diarrhea, colic and indigestion; paste applied to treat skin diseases (Sikkim: [11]). Decoction taken to get rid from fever (Darjeeling: [78]). Cut into small pieces and administered orally to treat stomach pain, loss of appetite and also used as antidote to food poisonong (Darjeeling: [52]).

696

Elettaria cardamomum (L.) Maton

Herb

Zingiberaceae

Used as medicine (KL Bhutan: [71]). Fruit: Used as spices (KL Bhutan: [70]).

Leaves: Used as incense (Taplejung: [81, 88]). Leaves and gum: Used as tonic and also useful in tuberculosis and internal hemorrhage (Sikkim: Database). Fruit: Boiled to obtain black ink (Taplejung: [87]).

We listed ailments as mentioned in the publications but we followed the method proposed by Cook [28] to classify plants according to the different ailment categories they used to cure. However, in some cases Cook’s categories were not precise enough and plants were assigned to additional ailment categories. Chi-square (χ2) was used to test the null hypothesis that there is no difference in use of NTFPs under various use categories among the three countries in the Kangchenjunga Landscape.

Pattern of publications

Majority of publications on NTFP were from India (60 %), while 34 % were from Nepal and 6 % from Bhutan. This is quite obvious as Darjeeling and the state of Sikkim in India make up a large part of the KL (56.3 %). The presence of two state level universities and research institutes has made significant contribution to the research in KL India [29]. Except for Bhutan, the species reported in this study were mostly documented through ethnobotanical studies conducted in different parts of the landscape. A few studies were focused on particular ethnic communities whereas most of the studies were on general ethnobotany of the region with mixed ethnic composition. Publication on NTFPs date back to 1988 in India while in Nepal and Bhutan it was started after 1996 (Fig. 2). However, majority of the publications (86 %) were published after 2000. All publications are qualitative in nature.

Fig. 2

Pattern of publications on NTFP from the Kangchenjunga Landscape

Frequency of NTFPs use

We reported on a total of 739 species of NTFPs used by the local people of Kangchenjunga Landscape. Of these, the highest number of NTFPs was documented from India (377 species), followed by Nepal (363) and Bhutan (245). These numbers, however, overlap in terms of distribution. The NTFPs used only in India were 185 species, while this number was 189 for Nepal and 166 for Bhutan.

Taxonomic diversity and growth habit

Angiosperms were predominant with 705 taxa belonging to 137 families followed by Gymnosperms (10), Pteridophytes (17), Fungi (3), Lichens (2), Bryophyte (1) and Algae (1). Families with the highest number of species used belong to Asteraceae (56 species), Fabaceae (41), Lamiaceae (27), Rubiaceae (24), Poaceae (23), Moraceae (16), Ranunculaceae (16), Rosaceae (15), Zingiberaceae (15), Polygonaceae (14), Ericaceae (13), Rutaceae (13), and Liliaceae (11). NTFPs were distributed into different life forms, with herbs having the most species followed by trees and shrubs (Fig. 3). Pattern of NTFPs used according to different life forms was similar in Bhutan, India and Nepal. Such herbaceous species were mostly medicinal and their extensive use could be because they were frequently found in the forest, and it is believed that the more abundant a plant is the more medicinal virtues it may possess [30].

Fig. 3

Frequency of NTFPs in different growth habits

Major use categories

People from Kangchenjunga Landscape used NTFPs for 24 different purposes (Table 2). A comparative analysis revealed that the highest number of use categories were reported from the Kangchenjunga Landscape region of India (20 categories) followed by Nepal (18) and Bhutan (14). Despite common occurrence of many species in India and Nepal, use pattern differed greatly in these two countries. Medicinal plants were among the main valuable NTFPs in the landscape. Of the total NTFPs, 334 species were used in traditional medicinal practice in India, whereas 297 species used in Nepal and 176 species used in Bhutan. A considerable number of species were also used as edibles as fruit, vegetables, and pickles in all three countries (Table 1 and Table 2). Fruit and shoots were the most frequently eaten parts.

Table 2

Major use categories of NTFPs and frequency of taxa reported from Kangchenjunga Landscape

Use category

Frequency of taxa reported

Total (Kangchenjunga Landscape)

Bhutan

India

Nepal

Basket

4

3

–

7

Broom

2

–

1

3

Cigarette wrapper

–

–

1

1

Detergent

–

1

–

1

Dye

12

6

6

23

Edible

62

46

130

191

Fencing

2

1

1

4

Fermentation

–

4

3

4

Fibre

10

4

4

15

Fish poisoning

–

1

1

2

Fodder

3

4

12

19

Fuel

–

1

1

2

Gum

4

–

–

4

Incense

19

3

13

33

Insecticide

–

2

1

3

Medicinal

176

334

297

598

Oil

6

2

7

7

Ornamental

5

1

–

2

Preservator

–

1

–

1

Roofing

2

–

–

2

Ritual

–

3

5

8

Spritual

–

1

1

2

Tea

1

4

4

8

Vetenery medicine

–

27

5

27

The relatively higher number of diversity in wild edible NTFPs in Nepal could be because of higher diversity of ethnic groups living in the lowland Tarai to highland regions. There was a significant difference (χ2 = 35.06, df =64, α = 0.05 and 1-α = 83.67) in medicinal plants use pattern in major disease/ailment categories in India and Nepal. These results indicate differences between the traditions of NTFP use in different cultures of India and Nepal. Similar results were also obtained from East Timor [31]. NTFPs use varies from site to site because of the heterogeneity of the community and different traditional practices by ethnic groups [14].

Among 739 species used by the local people, most species were used for a single (550 species) purpose, while fewer were used for two (147) or multiple (42) purposes. Local people were well aware of collecting seasons, mode of collection, and frequency of collection of specific parts of plant species. Medicinal plants such as Heracleum nepalense is plucked on the first Tuesday after the Teej festival. This practice is known as ‘Harlo’. The people believe that the medicinal plants plucked on that day are extremely effective and potent [32]. Similar practice of harvesting season can be found among the Amchis of the Himalaya where they believe that for better medicinal efficacy, specific parts of specific medicinal plants should be collected during specific seasons [33].

Ailments treated and preparation methods

The use of medicinal plant in treatment of particular ailment and the preparation method were not specified from Bhutan. In India and Nepal, a total of 27 major ailments were reportedly treated with medicinal plants with most species being used to treat multiple ailments (Table 3). Gastro-intestinal disorders; fever; cold, cough and sore throat; musculoskeletal disorders; injuries; dermatological infections; respiratory system disorders; nutritional disorders; and poisoning effects were treated with the highest diversity of medicinal plant species (Table 1 and Table 3). The high diversity of species use in gastro-intestinal disorders could be because of poor sanitation and drinking water quality in the Kangchenjunga Landscape as in many developing contries [34, 35].

Table 3

Major disease categories and number of taxa reported from Kangchenjunga Landscape

aMost taxa were reported to be used in more than one disease/ailment/condition category (see Table 1)

Mode of preparation included juice, paste, decoction, powder, infusion, and chewing raw plant parts (Fig. 4, Table 1). The majority of formulations were prepared as juice followed by paste and decoction. Proper selection of species, parts, as well as preparation and administration methods were very important in traditional health care systems.

Fig. 4

Use frequency (number of medicinal formulations) of different remedy preparation methods in India and Nepal

Almost all plant parts were used to prepare different medicinal formulations: roots, rhizomes, tubers, bark, leaves, flowers, fruit, seeds, young shoots, whole plants, and gum and latex (Table 1). The most frequently used plant parts were underground parts, followed by leaves, fruit, bark, whole plants, seeds and flowers (Fig. 5). Use of multiple plant parts was often documented (Table 1). The preference for roots and rhizomes to prepare traditional remedies follows the scientific basis that roots generally contain high concentrations of bioactive compounds [36]. Such a trend is also reported from other studies from the Himalaya [35, 37, 38].

NTFPs trade and livelihoods potential

The role of NTFPs is particularly important in the Himalayan region where a large proportion of the rural population depends on them as a source of medicine, food, fibre, dye and other useful materials [39–41]. In the Kangchenjunga Landscape, many of the NTFPs are used for subsistence, while others are the main or only source of income generation. However, the role of non-marketed NTFPs that were used for subsistence is largely ignorned when estimates are made of the economic importance of NTFPs to rural populations [42]. Understanding the economic value of non-marketed NTFPs helps to determine the true income of the gatherers and also helps ascertain the true value of the standing forest, leading to more rational decisions about its alternative uses [42].

Domestic as well as cross-border trade of NTFPs, both legally and illegally, is a historical practice in this region [43]. The traded NTFPs mostly include medicinal plants and to a lesser extent some wild edible plants and fibre yielding plants. The handmade paper from Argeli (Edgeworthia gardneri) is the only NTFPs that was sold after value addition in Nepal. Many of the species documented in this study possess high economic potential (Table 4) and could thus supplement family income [44] while generating incentives for biodiversity conservation [45].

Table 4

Major NTFPs traded (in kg) and revenue generated (USD) from 2008 to 2013 in the Nepal part of Kangchenjunga Landscape

Species/products and parts

Traded quantity (kg)

Revenue (USD)

Argeli (Edgeworthia gardneri)/Bark

97,000

4109

Ban lasun (Fritillaria cirrhosa)/Bulb

1500

150

Bish jara (Aconitum ferox)/Root

4300

301

Chiraito (Swertia chirayita)/Whole plant

88,765

7445.97

Chutro (Berberis wallichiana)/Bark

5000

NA

Daruhaldi (Mahonia napaulensis)/Bark

6500

130

Dhupi pat (Juniperus indica)/Twig

3800

76

Khayar (Acacia catechu)/Heartwood

97,784.6

38,456.88

Lauth salla (Taxus wallichiana)/Twig

290,500

9441.25

Lichen (Usnea sp., Parmelia sp.)/Whole plant

11,000

1650

Lokta (Daphne bholua)/Bark

71,076

1940

Majitho (Rubia manjith)/Whole plant

78,800

2199.24

Nagbeliko powder (Lycopodium clavatum)/Pollen grains

8000

160

Khoto (Pinus roxburghii)/Resin

1,256,334

9799.40

Ritha (Sapindus mukorossi)/Fruit

1600

48

Total

2,021,959.6

75,906.74

Source: Compiled from Hamro Ban - a yearly publication of Department of Forests, Ministry of Forests and Soil Conservation, Government of Nepal

Commonly traded NTFPs from the Nepal part of the Kangchenjunga Landscape include medicinal plants such as Dactylorhiza hatagirea, Fritillaria cirrhosa, Neopicrorhiza scrophulariiflora, lichens, and Taxus wallichiana. Other important species under trade are Aconitum species, Valeriana jatamansi, Viscum album and Zanthoxylum species. Species such as Daphne bholua, Edgerworthia gardnerii, Rhododendron anthopogan, Rubia manjith, Swertia chirayita, Valeriana jatamansi, and Zanthoxylum species are traded in large volume following legal procedures. The collected plant materials are normally sold to middlepersons (local traders), with only a few collectors selling or exporting NTFPs directly in local and cross-border markets. The total amount of NTFPs traded from Nepal in the last five years was 2,029,960 kg and the amout of revenue generated was around US$ 76,066 (Fig. 6, Table 4). The lack of openly accessible information on traded species of NTFPs from Bhutan and India limited our ability to conduct a comparative analysis.

Fig. 6

Amount of traded NTFPs (black bars) in ‘000 kg and revenue generated (grey bars) in USD in five years in the Nepalese part of the Kangchenjunga Landscape

Despite the high potential for trade and livelihoods through NTFPs, local people in the Kangchenjunga Landscape are not able to adequately benefit from engaging in the NTFP sector. In most cases, collectors were not aware of the market price for their products and were compelled to sell based on the offers of the middlepersons [46]. Thus, ensuring that market information is available to local people is one of the challenges in the NTFP sector in the landscape. Moreover, traders reported several other issues including multiple taxation system, hurdles during transportation, and duration of transport permit.

As reported by Sundriyal and Sundriyal [47] from Sikkim within the Kangchenjunga Landscape, the sale of fruit provides minimum returns due to fairly low shelf life and market costs. Therefore, some value addition in the form of pickle, chutney, jam, jelly, etc. may increase fruit shelf-life and economic profit to local communities. This reflects a clear need to diversify the product base and to ensure that wild edible plants fetch higher prices [47]. There is also need for value addition for other NTFPs. Therefore, value addition at the local level is an essential part of NTFP trade. Untapped but potential species of NTFPs such as wild edible fruit and vegetables could be promoted in local markets. These could also be promoted for visitors in hotels and restaurants.

Another major problem in commercialization of NTFPs is the low volume in which they are collected and produced, in contrast to the large quantities that are required for the markets. This problem could be addressed by establishing cooperatives, and using these cooperatives for collective marketing which will ensure optimum benefits to collectors [48].

Threats and conservation challenges

Unustainable harvesting of NTFPs, mostly medicinal and edible plants, is the major threat to conservation and management of NTFPs in the Kangchenjunga Landscape [47, 49]. Sustainable harvesting is essential for conservation of NTFPs, and in turn for ensuring the livelihoods of many rural peoples. Indeed, promotion of commercial extraction of NTFPs as a conservation strategy is based on the argument that forest conservation must be able to offer economic incentives to local peoples in order to counter the threat from destructive land uses such as logging and grazing. This strategy has gained wide acceptance as a conservation paradigm [2]. As indicated by Ticktin [2], despite growing concern over the conservation of these species, as well as their potential to enhance forest conservation and livelihoods, information on the ecological implications of harvest is not available in the Kangchenjunga Landscape.

Illegal trade of NTFPs from the landscape often includes some of the CITES Appendix listed species such as Sunakhari (Orchids), Kutki (Neopicrorhiza scrophulariiflora), and Lauth salla (Taxus wallichiana). The trade also includes some plant species under legal protection of the Government of Nepal like Orchids, Champ (Michelia champaca), Jhyau (Lichens), Jatamansi (Nardostachys grandiflora), and Sughandhawal (Valeriana jatamansi) [43]. These species are mostly traded to India via local collectors, whereas limited quantity of these items are exported to Tibet [50, 51]. Conserving such species is challenging, yet illegal trade has slightly decreased in the last decade due to effective conservation efforts of local organizations and increased cultivation practices in the landscape. Community forestry, which has restricted open access to NTFPs, and resource monitoring have also been effective in conserving NTFPs in recent years. In addition, availability of economically important NTFP species has currently declined due to deforestation and replacement with monoculture, use of pesticides and over harvesting [50]. Traditional knowledge on the use of NTFPs such as medicinal plants is also gradually declining due to socio-economic transformation in the Kangchenjunga Landscape [49, 52, 53].

Monitoring is one of the key components to promote the NTFP sector. Follow-up of rules, regulations and strategies related to NTFPs is necessary for contributing to changes in policy that are able to mainstream sustainable management of NTFPs with livelihoods improvement. Limited progress has been achieved in the Kangchenjunga Landscape in controling over-harvesting, enforcing effective harvesting regimes, and maintaining conducive and adaptive adminstrative processess. Recently adopted economic tools such as certification of sustainable harvests should also be applied as a means of ensuring that NTFPs collected sustainably can be identified as such by the consumers [54, 55].

NTFPs reported from the Kangchenjunga Landscape also include many species under different threat categories as well as under priorities of the governments. For example, of the total 30 national priority herbs of Nepal, 26 are abundantly available in the Kangchenjunga Landscape, while all species prioritized for cultivation and research in Nepal are also reported from the Landscape [56]. Among these, Nardostachys grandiflora, Neopicrorhiza scrophulariiflora, Rauvolfia serpentina and Taxus wallichiana are the most threatened species. Therefore, the economic, socio-cultural and conservation values of these NTFPs are extremely high.

NTFP policy frameworks

A comparision of NTFP policy frameworks in the Kangchenjunga Landscape shows that Bhutan, India and Nepal have supportive policies for the NTFP sector, thereby providing enabling environments and support for NTFP programs and marketing [25]. As a result, many development agencies including national and international non-governmental organizations have placed emphasis on NTFPs in their programs. The collection, conservation and sustainable utilization of NTFPs in Bhutan is mostly guided by the National Strategy for the Development of Non-Wood Forest Products 2008–2018. Other sectoral policies are the Forest Act 1969, Plant Quarantine Act of Bhutan 1993, Forest and Nature Conservation Act of Bhutan 1995, Environmental Assessment Act 2000 and Biodiversity Act and Framework of Bhutan 2003, 2006 [57]. The Indian National Forest Policy (1988) makes a special mention of NTFPs emphasizing on protection, improvement and their enhanced production for generation of employment and income [58]. Likewise, in Nepal there are several sectoral as well as specific policy provisions for sustainable use and management of NTFPs [15, 55]. The most comprehensive policy is the Herbs and Non-Timber Forest Product Development Policy 2004 [59]. The recent Nepal National Biodiversity Strategy and Action Plan 2014 and Forest Policy 2015 also emphasize sustainable use and management of NTFPs and critically provide special opportunity to support livelihoods of marginalized propoor and women through wise use of NTFP. Nevertheless, present policy formation, implementation and field reality reflects power structures and domination by certain stakeholders and interests [60].

Gender participation in policy formulation is also challenging. For example, 75 % of people collecting NTFPs in India were women and 100 % involved in NTFP processing were women, but their inclusion in Joint Forest Management committees was less than 10 % [61]. Similarly, in Nepal, although women contribute a large share of the labor for forest and biodiversity conservation in community forests, they represent only 22 % in the executive bodies of Community Forest User Groups [62]. Similar situation exists in Bhutan where the women’s involvement is generally low in the designing, planning, and implementation of forestry policies, and there is limited understanding of the roles, knowledge, aspirations and contributions made by women towards NTFP management [63].

Considerable efforts have been made to develop the NTFP sector, but the contribution of NTFPs in national economies remains insignificant. As pointed by Shackleton and Pandey [21], the reason behind this is that their economic value remains invisible to external observers as most NTFPs are used for household purposes; production and harvest of NTFPs is a seasonal event, with their use or trade involving only small quantities; much of the NTFP trade is via informal and closed markets which are hard to enumerate; production and markets is dispersed; and their use is highest in rural areas, which are often remote and marginalised in terms of human resources and development policies.

Gaps on knowledge based conservation and management of NTFPs

Like in other parts of the Himalayas, there is still a severe paucity of in-depth field based information on the abundance, reproductive biology and ecological impacts of harvesting of NTFPs in the Kangchenjunga Landscape. There is no standard method available to estimate the economic contribution of NTFPs and their products. Research on the inventory, life history of NTFPs, and impact of harvesting on the ecosystem is a prerequiste for their sustainable management, yet very few such activities have been documented from the landscape [64]. Similarly, ecological impacts of NTFPs harvesting for domestic and commercial purposes must be estimated to ensure their sustainability and the implementation for effective conservation measures.

Market size, structure and value chain of NTFP species depend on the demand and supply characteristics of products and their beneficiaries in different areas. Understanding market information is important for value addition and in devising investment strategies [16] for NTFPs based products, their diversification, and related enterprises. At present, the majority of NTFPs from the Kangchenjunga Landscape are traded in the raw forms, and NTFP harvesters lack necessary support for market-based strategies from both private, as well as government sectors.

Indigenous knowledge and management systems have been recognized for contributing to sustainable use of NTFPs, and consequently they have secured legal rights to manage forest resources [55]. In the Kangchenjunga Landscape, indigenous knowledge on NTFP use is well documented, but indigenous management systems need to be assessed and used for sustainable management.

We documented NTFPs collected and used for various purposes by the local people of the Kangchenjunga Landscape. The diversity of NTFPs was highest in India, followed by Nepal and Bhutan. Though the landscape possesses many potential species for trade, their nominal contribution to local livelihoods was due to lack of value addition and commercialization. Unsustainable harvesting and lack of value addition and commercialization could be considered as major challenges for conservation and development of the NTFP sector in the landscape.

Tracing the trend of NTFP research and exploitation, it shows much focus on medicinal plants resulting in over-harvesting of some highly potential medicinal plants, with very negligible amount of other plant species reported for other purposes. At present, NTFPs are synonymous with medicinal and aromatic plants and vice versa. Only small amounts of other NTFPs are marketed. Therefore, research must also focus on other potential categories of NTFPs. NTFP collectors need to be educated about forest ecology and the adverse impacts of unsustainable harvesting for conservation and local livelihoods. Sustainable harvesting techniques should be provided through training and capacity building programs to local people. Biological studies of high value NTFPs must be carried out in order to ensure sustainability of these resources.

Phytochemical screening of medicinal plants and nutrient value analysis of wild edible plants would foster their commercialization. Traditional knowledge of medicinal plant use could be integrated with ‘modern’ health care systems [65]. Highly potential NTFPs must be identified and grown for commercial cultivation and adopted in traditional agroforestry systems. This will reduce pressure on these species in their natural environments while providing economic benefits to poor farmers [47].

Conservation and development organizations, together with government agencies and private sectors, must provide technical and innovative inputs to add value to NTFP products. They must also facilitate community mobilization for assessment and identification of potential NTFPs. The latter role will be of significant importance considering the limited human and financial resources of government agencies in the Kangchenjunga Landscape. An integrated approach will promote sustainable use of NTFPs while contributing to income generation and livelihood improvement for local people. Transboundary landscape conservation programs will provide opportunities for transboundary cooperation through policy reforms, as well as providing opportunities to diversify livelihoods of forest dependent communities. However, marketing and commercialization of NTFPs can be successful only if the activity is transparent, equitable and sustainable, with important implications for poverty reduction and better resource management [20]. Increasing access to NTFP-selling outlets could be achieved through information dissemination, empowerment of collectors and establishment of linkages between collectors and traders [41]. The role of small and medium sized enterprises and cooperatives is extremely important to achieve sustainable management of NTFPs.

Acknowledgements

The authors would like to recognize the support of the Austrian Development Agency (ADA) and the German Agency for International Cooperation (GIZ) for their financial support through International Centre for Integrated Mountain Development (ICIMOD).

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

YU, RCP, NC, and RPC designed the study. YU, RCP and NC carried out the literature search. YU, RCP, JG, NC and RPC analyzed the data and wrote the manuscript. All authors approved the final version of the manuscript.

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